Saturday, January 08, 2011

It struck me that Ginny The Highly Inappropriate Chaplain has a much, much harder job than I do.

Nurses like to bitch. It's what we do to ameliorate the hell of being a nurse, of being torn between the lab and the doctor or the patient and the family or the law and ethics. We bitch, we moan, we make bad, bad graveyard jokes that anybody not in the profession would blanch to hear. But, at the end of the day, we have one tool in our arsenal that nobody else in the hospital has:

We're the ones that make patients feel better.

Think about it: if you're hurting, or you have indigestion, or you have some weird itchy rash that needs to be taken care of, who do you ask for help? You hit your call bell and you ask your nurse. And your nurse either brings you pain medicine or gets you some Maalox or finds you some magical cream to help your owie. Nobody else in the hospital can do that as reliably as we can. Sure, it's a pain in the ass sometimes to call doctors or fight for pain relief or get a scrip for X Miracle Cream, but we do it, and people feel better as a result.

It must be hard to be a hospital chaplain, because things just aren't that easy for them.

The chaplains have to deal not only with the people who are hurting and afraid, but with family members who are probably hurting more and are more frightened than the patients. Believe me: when you're a patient facing down a surgery, fear is a minor part of what you're feeling. Other people are handling that for you; you're much more concerned about whether the anesthetic will work or if you'll spill your guts in post-op, then vomit uncontrollably.

We nurses deal with specifics. You hurt, I bring you pain medicine. You've had a stroke and so your left arm is weak, so I teach you how to strengthen it.

Chaplains deal with the tough shit. Why is this happening to me? I didn't do anything to deserve this; why do I have to go through it? Is giving up a bad thing? Is giving up on Mom or Dad or Grandma a bad thing? Is it really giving up, if you think that maybe that person is ready to go? Am I ready to let them go? What, exactly, does letting go mean?

Why does God let things like this happen?

We nurses deal with specifics. Why does my body do X and Y when my brain has done Z? There are concrete answers to that. After enough time, every nurse can say with confidence that he's seen this sort of thing before, and this is what you have to expect in the future.

Chaplains don't get that certainty. They get certainty of a sort, because without a belief in some sort of Greater Good, they wouldn't be chaplains. What they don't get, though, is easy answers, or concrete examples, or even the ability to reassure people that, while things seem unfair, they really do end up moving toward good. All of that is predicated on a much, much longer timeframe and bigger scale than we humans have.

We may bitch, but we have specific, timed, and measurable goals to hit. We have ways of judging our performance that people whose care is focused on the soul don't have. They do what they can and trust to the future and take their comfort where they find it in a way that we don't have to. We're lucky: we might deal with blood and puke and shit all day, but they deal in pain and loss and sadness. And occasionally reconcilliation and hope, but I think probably less than they'd like to.

I'm reminded of something that Susan Palwick said in one of her ER poems over at Rickety Contrivances of Doing Good: it's so easy for *us* to feel holy when *they're* asleep. That, I suspect, is the only break people like Ginny get.

12 comments:

Oddly enough, though, I think I have the easier of the two jobs (which is probably why I'm not a nurse!). First of all, I never ever have to stick anybody with needles. Being a medical caregiver means that often you have to hurt people in the service of helping them: chaplains don't have to do that.

Secondly, our job isn't to fix anything. It's to help patients and families marshall the inner resources -- their own sources of strength -- that become so crucial in times of illness. In other words, it's to help remind them of what they already know has the power to heal them (and healing of some sort is always possible, even when medical cure isn't). Faith, friends and family are usually very high on that list, but over the six years I've been volunteering as a chaplain, I've talked to patients with lots of other tools: pets, cooking, art, nature, motorcycles, TV shows, music, you name it.

Third, I'm not the One in charge. A mantra we learned during training reminds us that "God was in the room before you got there, and God will be in the room after you leave."

Sure, it's hard sometimes, but so's nursing. And I like talking to people about big questions. I'd sure rather do that than have to place an IV! I usually don't have answers, but that doesn't bother me. Patients find it comforting to see other people grappling with these issues, too. It's a reminder that we're all in this together.

The bottom line for both you and me, I think, is that we're privileged to be able to help patients and famiies the way we do, whether that's through conversation or medication.

Thank you, thank you Head Nurse. I'll take all the hugs I can get. I work in hospice as a staff chaplain, and I find that in the demographic where I work (and believe me this varies STRONGLY) many people do not in fact want to talk about God or religion; I say prayer maybe 1/3 of the time; I deal with lots of patients and families who have been badly hurt by churches or by crap theology. Also I am not especially romantic and I do not believe that "the right thing always happens" or that "things turn out the way they should." LOVE Kate Braestrup's writing, and it is the Maine State Game Warden Service for which she is chaplain; she has much to say about presence and how that looks. I find that for some people the best help is to hold space for them to go to their darkest fears/hurts/rage at God, and be with them there so they are not alone, and not try to talk them out of any of it; that, from someone wearing a chaplain badge, can provide an opening to a "bigger" view of religion and the divine than has been possible, or not, as is needed. And, sometimes in hospice, we do have to "cause pain," in saying gently, yes, your loved one is dying, no, what you're seeing is not improvement, yes, you do need to decide, and no, there is no guarantee your decision is "THE right one." I work, btw, with an AWESOME crew of RNs, CNAs, and MDs, and I take my hat off to them a million times a day. I never cease to be amazed by what they can and do accomplish, in bringing comfort and dignity and love. I love my work and the team I am lucky enough to work with, more than I can say.

Our chaplains are the best. They are compassionate and *very* widely-read, which is something I deeply respect. They can address *any* spiritual issue from *any* religious tradition. Catholics, Muslims, evangelicals, Buddhists, even the occasional Asterisk-Worshipper.